NPIMap

Organization Active NPI

Red Core PT Pta and Rehabilitation PLLC

Doing business as Redcore Physical Therapy

  • Physical Therapist
  • Ridgewood, NY
National Provider Identifier
1043698228
Registry record updated Jan 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
027246-1 Issued in NY
Legal business name
RED CORE PT PTA AND REHABILITATION PLLC
Doing business as
Redcore Physical Therapy
Redcore Physical Therapy And Rehabiitation
Practice address
311 St Nicholas Avenue
Suite E- Basement
Ridgewood, NY 11385
Phone
(718) 509-9888
Fax
(718) 509-6144
NPI assigned
May 8, 2015
Last updated
Jan 29, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Eduard Kho, PTNPI 1134495161
Title
Senior Physical Therapist
Phone
(718) 509-9888

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 027246-1 NY Primary

Addresses

Primary practice location

311 St Nicholas Avenue
Suite E- Basement
Ridgewood, NY 11385

Mailing address

P.O. Box 780173
Maspeth, NY 11378
Phone (718) 509-9888

Other practice location 1

1718 Pitkin Ave
Brooklyn, NY 11212-6604
Phone (718) 509-9888

Other practice location 2

4626 White Plains Rd
Bronx, NY 10470-1610
Phone (718) 509-9888

Other identifiers 1

IdentifierTypeStateIssuer
04599515MedicaidNY

Other names 2

  • Redcore Physical Therapy Doing business as
  • Redcore Physical Therapy And Rehabiitation Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160616000776 NY Part B Supplier - Clinic/Group Practice 4880985175 Receives reassigned benefits from 5 practitioners
4 other NPIs on this enrollment
Practice locations: Bronx, NY; Brooklyn, NY

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Red Core PT Pta and Rehabilitation PLLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1431043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706486400000",
    "number": "1043698228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 780173",
            "city": "MASPETH",
            "state": "NY",
            "postal_code": "11378",
            "telephone_number": "718-509-9888",
            "fax_number": "718-509-6144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 ST NICHOLAS AVENUE",
            "address_2": "SUITE E- BASEMENT",
            "city": "RIDGEWOOD",
            "state": "NY",
            "postal_code": "11385",
            "telephone_number": "718-509-9888",
            "fax_number": "718-509-6144"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1718 Pitkin Ave",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112126604",
            "country_code": "US",
            "telephone_number": "718-509-9888",
            "fax_number": "718-509-6144",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4626 White Plains Rd",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104701610",
            "country_code": "US",
            "telephone_number": "718-509-9888",
            "fax_number": "718-509-6144",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "RED CORE PT PTA AND REHABILITATION PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-08",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-29",
        "status": "A",
        "authorized_official_last_name": "KHO",
        "authorized_official_first_name": "EDUARD",
        "authorized_official_title_or_position": "SENIOR PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "718-509-9888",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "027246-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04599515",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Redcore Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Redcore Physical Therapy And Rehabiitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ridgewood, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.